Breast cancer facts
Breast cancer is the most common cancer.
There are many types of breast cancer that differ in their capability of spreading (metastatize) to other body tissues.
The causes of breast cancer are not yet fully known, although a number of risk factors have been identified.
There are many different types of breast cancer.
Breast cancer symptomsand signs include
a lump in the breast or armpit,
bloody nipple discharge,
orange-peel texture or dimpling of the breast’s skin,
breast pain or sore nipple,
swollen lymph nodes in swollen lymph nodesthe neck or armpit, and
a change in the size or shape of the breast or nipple.
Breast cancer is diagnosed during a physical exam, by self-examination of the breasts,mammography, ultrasound, testing, and biopsy.
Treatment of breast cancer depends on the type of cancer and its stage (0-IV) and may involve surgery,radiation, or chemotherapy.
What are the different types of breast cancer? Where does breast cancer come from?
There are many types of breast cancer. Some are more common than others, and there are also combinations of cancers. Some of the most common types of cancer are as follows:
Ductal carcinoma in situ: The most common type of noninvasive breast cancer is ductal carcinoma in situ (DCIS). This type of cancer has not spread and therefore usually has a very high cure rate.
Invasive ductal carcinoma: By starting in a duct of the breast, this cancer grows into the surrounding tissue. It is the most common form of breast cancer.
Invasive lobular carcinoma: This breast cancer starts in the glands of the breast that produce milk.
The remainder of breast cancers are much less common and include the following:
Mucinous carcinoma are formed from mucus-producing cancer cells. Mixed tumors contain a variety of cell types.
Medullary carcinoma is an infiltrating breast cancer that presents with well-defined boundaries between the cancerous and noncancerous tissue.
Inflammatory breast cancer: This cancer makes the skin of the breast appear red and feel warm (giving it the appearance of an infection). These changes are due to the blockage of lymph vessels by cancer cells.
Triple-negative breast cancers: This is a subtype of invasive cancer with cells that lack estrogen and progesterone receptors and have no excess of a specific protein (HER2) on their surface. It tends to appear more often in younger women and African-American women.
Paget’s disease of the nipple: This cancer starts in the ducts of the breast and spreads to the nipple and the area surrounding the nipple. It usually presents with crusting and redness around the nipple.
Adenoid cystic carcinoma: These cancers have both glandular and cystic features. They tend not to spread aggressively and have a good prognosis.
The following are other uncommon types of breast cancer:
What are breast cancer medical treatments?
Patients with breast cancer have many treatment options. Most treatments are adjusted specifically to the type of cancer and the staging group. Treatment options should be discussed with a health care team. The following are the basic treatment modalities used in the treatment of breast cancer.
Most women with breast cancer will require surgery. Mainly, the surgical therapies for breast cancer can be categorized into mastectomy and breast-conserving surgery.
This surgery will only remove part of the breast (sometimes referred to as partial mastectomy). The extent of the surgery is determined by the size and location of the tumor.
In a lumpectomy, only the breast lump and some surrounding tissue is removed. The surrounding tissue (surgical margins) are inspected for cancer cells. If no cancer cells are found, this is called “negative” or “clear margins.” Frequently, radiation therapy is given after lumpectomies.
During a mastectomy (sometimes also referred to as a simple mastectomy), all the breast tissue is removed. If immediate reconstruction is considered, a skin-sparing mastectomy is sometimes performed. In this surgery, all the breast tissue is removed as well, but the overlying skin is preserved.
During this surgery, the surgeon removes the axillary lymph nodes as well as the chest wall muscle in addition to the breast. This procedure is done much less frequently than in the past, as in most cases, a modified radical mastectomy is as effective.
Modified radical mastectomy
This surgery removes the axillary lymph nodes in addition to the breast tissue. Depending on the stage of the cancer, a health care team might give someone a choice between a lumpectomy and a mastectomy. Lumpectomy allows sparing of the breast but usually requires radiation therapy afterward. If lumpectomy is indicated, long-term follow-up shows no advantage of a mastectomy over the lumpectomy.
For a small group of patients who have a very high risk of breast cancer, surgery to remove the breasts may be an option. Although this reduces the risk significantly, a small chance of developing cancer remains. Double mastectomy is a surgical option to prevent breast cancer.
Radiation therapy destroys cancer cells with high energy rays. There are two ways to administer radiation therapy.
External beam radiation
A radiation beam is concentrated onto the affected area by an external machine. The extent of the treatment is determined by a health care team and is based on the surgical procedure performed and whether lymph nodes were affected or not.
The local area will usually be marked after the radiation team has determined the exact location for the treatments. Usually, the treatment is given five days a week for five to six weeks.
This form of delivering radiation uses radioactive seeds or pellets. Instead of a beam from the outside delivering the radiation, these seeds are implanted into the breast next to the cancer.
Chemotherapy is treatment of cancers with medications that travel through the bloodstream to the cancer cells. These medications are given either by intravenous injection or by mouth.
Chemotherapy can have different indications and may be performed in different settings as follows:
Adjuvant chemotherapy: If surgery has removed all the visible cancer, there is still the possibility that cancer cells have broken off or are left behind. If chemotherapy is given to assure that these small amounts of cells are killed as well, it is called adjunct chemotherapy.
Neoadjuvant chemotherapy: If chemotherapy is given before surgery, it is referred to as neoadjuvant chemotherapy.
Chemotherapy for advanced cancer: If the cancer has metastasized to distant sites in the body, chemotherapy can be used for treatment.
Estrogen promotes the growth of a few breast cancers, specifically those containing receptors for estrogen (ER positive) or progesterone (PR positive).
As we are learning more about gene changes and their involvement in causing cancer, drugs are being developed that specifically target the cancer cells.
Whenever a disease has the potential for much harm and death, physicians search for alternative treatments. The danger in this approach is usually found in the fact that the patient might not avail themselves of existing, proven therapies. One should discuss any interest in alternative treatments with a health care team and together explore the different options.